TRENDS IN SMALL HOSPITAL MEDICAL-SERVICES IN ONTARIO

OBJECTIVE To compare the medical services provided in small hospitals in Ontario in 1995 with those provided in 1988. DESIGN Mailed survey q uestionnaire. SETTING Small hospitals in Ontario. PARTICIPANTS Chiefs of Staff of the hospitals. MAIN OUTCOME MEASURES Hospital size and loc ation; numbers of physicians; availability of obstetric, anesthesia, a nd general surgery services; and other medical services available. The 1995 questionnaire was identical to the 1988 one, except for addition of questions on midwives and deletion of the detailed emergency medic ine section. RESULTS Sixty hospitals responded in both years. In these hospitals, there were significantly fewer acute care beds and births in 1995 than in 1988. Availability of general anesthesia and general s urgery was significantly reduced, although general anesthesia was admi nistered and general surgeries were performed more often. There were s ignificantly fewer GP anesthetists and significantly fewer family phys icians who attended births, although there were slightly more family p hysicians overall. There were fewer specialists. CONCLUSION These are negative trends, particularly for women giving birth and patients need ing emergency surgery in rural Ontario.